Artificial surface effect on red blood cells and platelets in laminar shear flow

Red blood cell (RBC) effects on platelet adhesion to a nonbiologic test surface (tetrafluoroethylene propylene copolymer) and platelet aggregation during laminar shear flow for shear rates to 5,680 s-1 (corresponding to shear stress to 200 dyne/cm2) were investigated. Results on hemoglobin (Hb) and adenosine diphosphate (ADP) release from RBCs, percent decrease of single platelets in the bulk, and percent of test surface covered with platelets were obtained in a cone-and-plate (CP) viscometer for samples of whole blood, suspensions of RBC ghosts in platelet-rich plasma (PRP), and suspensions of RBCs in either PRP or platelet-poor plasma. Results obtained over the shear rate range studied for samples of normal hematocrit indicated that low-stress shearing led to ADP and Hb release from intact RBCs; shear-induced release of ADP from RBCs was about twice that of platelets, and of the total ADP released, the ADP released from RBCs contributed about six times that of the platelets to single platelet reduction in the bulk and about twice that of the platelets to platelet adhesion, ie, coverage of the test surface with platelets. Results obtained for various hematocrits showed that above a threshold hematocrit of about 25% to 35% the RBCs (suspended in PRP) had a greater contribution to ADP release, platelet adhesion, and platelet aggregation than the platelets themselves. Single platelet reduction for samples of RBC ghosts suspended in PRP correlated with shear rate level and not with shear stress.</jats:p

Artificial surface effect on red blood cells and platelets in laminar shear flow

Abstract Red blood cell (RBC) effects on platelet adhesion to a nonbiologic test surface (tetrafluoroethylene propylene copolymer) and platelet aggregation during laminar shear flow for shear rates to 5,680 s-1 (corresponding to shear stress to 200 dyne/cm2) were investigated. Results on hemoglobin (Hb) and adenosine diphosphate (ADP) release from RBCs, percent decrease of single platelets in the bulk, and percent of test surface covered with platelets were obtained in a cone-and-plate (CP) viscometer for samples of whole blood, suspensions of RBC ghosts in platelet-rich plasma (PRP), and suspensions of RBCs in either PRP or platelet-poor plasma. Results obtained over the shear rate range studied for samples of normal hematocrit indicated that low-stress shearing led to ADP and Hb release from intact RBCs; shear-induced release of ADP from RBCs was about twice that of platelets, and of the total ADP released, the ADP released from RBCs contributed about six times that of the platelets to single platelet reduction in the bulk and about twice that of the platelets to platelet adhesion, ie, coverage of the test surface with platelets. Results obtained for various hematocrits showed that above a threshold hematocrit of about 25% to 35% the RBCs (suspended in PRP) had a greater contribution to ADP release, platelet adhesion, and platelet aggregation than the platelets themselves. Single platelet reduction for samples of RBC ghosts suspended in PRP correlated with shear rate level and not with shear stress.</jats:p

Where do the platelets go? A simulation study of fully resolved blood flow through aneurysmal vessels

Despite the importance of platelets in the formation of a thrombus, their transport in complex flows has not yet been studied in detail. In this paper we simulated red blood cells and platelets to explore their transport behaviour in aneurysmal geometries. We considered two aneurysms with different aspect ratios (AR = 1.0, 2.0) in the presence of fast and slow blood flows (Re = 10, 100), and examined the distributions of the cells. Low velocities in the parent vessel resulted in a large stagnation zone inside the cavity, leaving the initial distribution almost unchanged. In fast flows, an influx of platelets into the aneurysm was observed, leading to an elevated concentration. The connection of the platelet-rich cell-free layer (CFL) with the outer regions of the recirculation zones leads to their increased platelet concentration. These platelet-enhanced recirculation zones produced a diverse distribution of cells inside the aneurysm, for the different aspect ratios. A thin red blood CFL that was occupied by platelets was observed on the top of the wide-necked aneurysm, whereas a high-haematocrit region very close to the vessel wall was present in the narrow-necked case. The simulations revealed that non-trivial distributions of red blood cells and platelets are possible inside aneurysmal geometries, giving rise to several hypotheses on the formation of a thrombus, as well as to the wall weakening and the possible rupture of an aneurysm

Prediction of bleeding and prophylactic platelet transfusions in cancer patients with thrombocytopenia

Studies on markers for bleeding risk among thrombocytopenic cancer patients are lacking. This prospective observational cohort study investigated whether platelet parameters and a standardised bleeding questionnaire predicted bleeding or prophylactic platelet transfusions in patients with cancer and thrombocytopenia. Admitted adult patients with cancer and platelet count &lt;80 × 10(9)/L were enrolled, but excluded if they experienced surgery or trauma within 7 days or platelet transfusion within 14 days. Patients were interviewed, blood samples collected and, subsequently, spontaneous bleeding and prophylactic platelet transfusion within 30 days were registered. Of 197 patients enrolled, 56 (28%) experienced bleeding. In multivariate analyses, predictors of bleeding were infection (adjusted odds ratio (OR) = 2.65 and 95% confidence interval (95% CI) 1.04-6.74); treatment with platelet inhibitors, heparin or warfarin OR = 2.34, 95% CI 1.23-4.48; urea nitrogen OR = 1.15, 95% CI 1.07-1.25; creatinine OR = 1.01, 95% CI 1.01-1.01; and haemoglobin OR = 0.62, 95% CI 0.41-0.93. Specific information regarding previous gastrointestinal bleeding OR = 3.33, 95% CI 1.19-9.34 and haematuria OR = 3.00, 95% CI 1.20-7.52 predicted bleeding whereas the standardised bleeding questionnaire did not. Prophylactic platelet transfusions were administered to 97 patients. Predictors of prophylactic platelet transfusions were: platelet count OR = 0.96, 95% CI 0.94-0.97; fibrinogen OR = 0.88, 95% CI 0.83-0.95; mean platelet volume OR = 0.69, 95% CI 0.49-0.97; platelet aggregometry with OR = 2.48, 95% CI 1.09-5.64 for collagen-induced platelet aggregation within the lowest quartile; and albumin OR = 1.07, 95% CI 1.01-1.15. In conclusion, except for immature platelet fraction (IPF), platelet parameters predicted prophylactic platelet transfusion but not bleeding. Bleeding risk factors were previous haematuria or gastrointestinal bleeding, infection, antiplatelet or anticoagulant treatment, high urea nitrogen, low haemoglobin or high creatinine.</p